Session Information
Title: Rheumatoid Arthritis - Clinical Aspects II: Clinical Features & Comorbidity/Cardiovascular Disease
Session Type: Abstract Submissions (ACR)
Background/Purpose: The prevalence of periodontal disease is known to be increased in patients with rheumatoid arthritis (RA) compared to the general population. We investigated whether severity of periodontal disease is associated with RA and correlated with RA disease activity, ACPA status or treatment medication.
Methods: We conducted a cross-sectional study comparing 295 RA patients and 88 non-arthritis controls. In RA patients, serum RF, anti-CCP antibody, CRP and ESR were measured. Clinical parameters including tender joint count (TJC), swollen joint count (SJC), DAS28 and presence of erosive changes in X- ray were evaluated at the time point obtaining samples. In all subjects, a number of teeth (0~28, 3rd molars excluded) was checked. Subjects who had 15 or more teeth were evaluated for dental exam and checked for P. gingivalis antibody. Plaque index (PI) was evaluated as a marker of dental hygiene and gingival index (GI), probing pocket depth (PPD), bleeding on probing (BOP) and clinical attachment loss (CAL) were evaluated as index of periodontitis. Periodontitis was defined as mild (CAL 1~2 mm), moderate (CAL 3~4 mm) and severe (CAL ≥ 5mm) by American Academy of Periodontology 2004 Classification.
Results: The mean number of teeth (±SD) in 295 RA patients and 88 controls were 23.4 ± 6.2 vs. 25.8 ± 2.9, respectively (p= 0.001). Among 290 RA patients, 28 patients (8.8%) had less than 15 teeth and 3 patients had ongoing dental care, both were excluded from the dental exam. Mean PI in 264 RA patients and 88 controls were 0.84 ± 0.49 and 0.70 ± 0.34 (p=0.014), mean GI 0.51 ± 0.43 vs. 0.15 ± 0.18 (p < 0.001), mean PPD 2.0 ± 0.4 vs. 1.7 ± 0.2 (p < 0.001), mean BOP 20.1 ± 15.4 vs. 12.3 ± 11.0 (p < 0.001) and mean CAL 3.2 ± 0.8 vs. 2.9 ± 0.5 (p < 0.001). The prevalence of moderate or severe periodontitis was significantly higher in RA patients compared to controls (63.6% vs. 33.3%, p< 0.001). Mean P. gingivalis antibody level (±SD) was higher in RA compared to control (34227 ± 55100 vs. 18341 ± 13147 unit/mL, p< 0.001). In RA patients, presence of dry mouth was associated with higher BOP (p= 0.022). Disease duration was associated with higher GI (r2= 0.044, p= 0.002) and BOP (r2= 0.022, p= 0.016). The patients with high positive anti-CCP antibody (≥ 15 IU/mL) showed higher GI than patients with negative (< 5 IU/mL, p= 0.002) or low positive (≥ 5 and < 15 IU/mL, p=0.046) anti-CCP antibody. There was no significant association between severity of periodontitis and RA disease activity markers (TJC, SJC, ESR, CRP, DAS28), presence of bone erosion, rheumatoid factor or use of steroid or biologic agents.
Conclusion: Patients with RA had more severe periodontal index than controls. Severity of periodontitis was associated with the presence of dry mouth, anti-CCP antibody and RA disease duration but not with disease activity.
Disclosure:
I. A. Choi,
None;
J. H. Kim,
None;
K. H. Kim,
None;
H. W. Kim,
None;
M. J. Yoon,
None;
B. S. Ku,
None;
H. Oh,
None;
J. Y. Lee,
None;
E. Y. Lee,
None;
E. B. Lee,
None;
Y. M. Lee,
None;
Y. W. Song,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/periodontal-disease-is-associated-with-rheumatoid-arthritis-but-its-severity-is-not-correlated-with-rheumatoid-arthritis-disease-activity/